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| | A New Weapon Against Insurance Fraud – Refuse to Write Insurance In That State By Barry Zalma, An Editorial - September 28, 2010Insurance Fraud, as I have said for the more than 14 years I have written ZIFL (Zalma Insurance Fraud Letter), is a serious problem that requires the attention of insurance professionals, police agencies, and prosecutors. Readers of ZIFL are just those professionals who care about the need to limit the extent of insurance fraud whether by insurers or by those insured. The problem faced by many insurance professionals is the lack of concern stated by local police and prosecutorial agencies. Some states and localities are more aggressive than others. If you practice in a state that is not as aggressive as it should be, you can take inspiration from Explorer Insurance.
Explorer has taken a positive step that might cause police and prosecutorial agencies to rethink their position, and aggressively arrest, prosecute and sentence insurance fraud perpetrators. Explorer Insurance announced late in August 2010 that it will no longer write private automobile policies in Florida because there is too much fraud. According to press reports: "The company is taking this action in light of poor ongoing business results in Florida, particularly in the area of private passenger automobile no-fault coverage, in which loss fraud has been rampant with no signs of abatement," Explorer vice president, Steve Frisina, said in the letter to Florida's Office of Insurance Regulation.
The letter said Explorer intends to send termination notices to agents who sell its coverage within a week of the Office's acceptance of its plan. Policy holders will begin receiving non-renewal notices also within one week. And, by January 2012, no Explorer policies will remain in effect.
The Office has deferred accepting Explorer's plan for the time being until the company can fix some of the details of its exit. In the meantime, however, Explorer has severely restricted the number of policies its agents are allowed to write and has told agents it is no longer paying commissions.
In May, the National Insurance Crime Bureau released a report that said that Florida has led the nation in suspected staged auto accidents the last three years in a row. According to the report, Florida had 3,006 suspicious claims from 2007 to 2009, and that was almost twice as many as the two states with the next most suspicious claims, New York and California.
According to NICB, Tampa had the most fraudulent claims. Local insurance agents are frustrated by the situation, and by the lack of government action to crack down, they are collecting petition signatures from new policy and renewal clients and forwarding that petition on to the Department of Financial Services, which houses the Division of Insurance Fraud.
Explorer, which is based in Santa Clarita, California, is a member company of the ICW Group, San Diego. Until now, it has sold automobile policies only in California and Florida.
Actions like that taken by Explorer may be the only way to get the attention of police and prosecutorial agencies. If more insurers leave the market, the state insurance departments, fraud bureaus, police agencies and prosecutors may become more aggressive in prosecuting fraud to avoid losing insurers willing to write insurance in their state. Insurers who present reports of potential fraudulent claims to their state and local agencies and only obtain no response should consider emulating Explorer.
Barry Zalma is a Certified Fraud Examiner and an attorney. He acts as an expert witness for insurance fraud cases. Readers may write to Barry Zalma at zalma@zalma.com. |